2 June, 2023

Endoscopic Sleeve Gastroplasty vs Stomach Stapling

Individuals who wish to lose weight have been looking for help and easier ways to accomplish this objective since the dawn of time. There are historical accounts of people consuming only alcohol or a strict diet of vinegar and water to shed some pounds.

Fortunately, medical researchers have also been working diligently to discover new techniques and invent new tools that can help with the medical interventions available for treating obesity. Let’s take a look at how far things have come in the past five decades, migrating from procedures like stomach stapling to endoscopic sleeve gastroplasty.

What Exactly Is Stomach Stapling?

Back in the seventies, researchers were looking for alternatives to weight loss surgery that would be safer than the jejunoileal bypass (a surgical short bowel) or Roux-en-Y (gastric bypass surgery). Mechanical surgical staplers were introduced and the first gastroplasty (stomach stapling surgery) was performed.

The old stomach stapling procedure was performed by placing a line of staples running the entire length of the stomach, separating it into two sections. One section was significantly smaller than the other and was designed to be used as the primary stomach. There was a small opening left between the primary stomach and the lower portion, and the food would gradually move through the smaller side and travel to the larger side during digestion.

The procedure seemed to deliver significant weight loss of about 50% of the patient’s excess body weight in one year but the long-term weight loss results were far worse.

Side Effects of Stomach Stapling

Stapling the stomach led to many side effects, such as the following:

  • Leaking fluids from the line of staples;
  • Staples releasing;
  • Issues with malnutrition;
  • Stenosis between the stomach sections (the opening would become smaller or close up);
  • The opening between the two sections of the stomach can become wider, increasing the speed at which the primary stomach empties and resulting in the patient overeating;
  • The primary side of the stomach would stretch out, increasing the amount of food the patient could eat during one meal.

Many unsuccessful modification attempts were made, but stomach stapling remained plagued by poor weight loss results and a high number of complications, so it was discontinued. Newer procedures were introduced, such as gastric sleeve surgery, which is now the most popular form of bariatric surgery.

How Does The Old Stomach Stapling Procedure Compare to Gastric Sleeve Surgery?

The gastric sleeve procedure was not originally a stand-alone surgery; it was the first part of a procedure that required two different surgeries, with time to heal in between. Duodenal switch surgery was developed to treat obesity and address the complication of bile reflux. This surgery involved the creation of the gastric sleeve as part one of the procedure. Enough patients showed significant weight loss after the gastric sleeve portion of the procedure that they began using it as a stand-alone surgery. Today gastric sleeve surgery is the most often performed bariatric surgery in the United States.

Surgical staples are used during gastric sleeve surgery, but things have improved over the past 50 years. There is no comparison between the old mechanical staplers that were bulky and unreliable and were used for stomach stapling versus gastric sleeve surgery and the more advanced, streamlined surgical staplers.

Gastric sleeve surgery is most often performed laparoscopically today but still requires the use of staples and has its fair share of complications.

Endoscopic Sleeve Gastroplasty vs Stomach Stapling

After the emergence of gastric sleeve surgery, advancements in medical technology and techniques continued to improve and endoscopic procedures for weight loss became available. New endoscopic tools were also created, including a state-of-the-art endoscopic suturing device.

Fortunately, there is no need for endoscopic stomach stapling because the new FDA-approved Overstitch device does a safe and effective job of securing tissue with full-thickness stitches. The overstitch device made it possible for gastroenterologists to repair complications from a previous bariatric surgery without the patient having to undergo an additional surgical procedure. And even more exciting is that it paved the way for a new non-surgical weight loss procedure called the endoscopic sleeve gastroplasty (ESG).

How Does Endoscopic Sleeve Gastroplasty Compare To Stomach Stapling?

The old gastroplasty procedure that was done with staples was a decent concept; they just did not have the right tools or technique. Today’s endoscopic sleeve gastroplasty (ESG) is a bit like a combination of the old stomach stapling procedure and modern gastric sleeve surgery, only much improved!

Gastric Sleeve vs Endoscopic Sleeve Gastroplasty
vs Stomach Stapling Comparison Chart
Gastric SleeveOld Stomach StaplingNon-Surgical ESG
Process
75% to 80% of the patient’s stomach is surgically removed, and the rest is stapled together.The patient’s stomach was divided into two parts using a line of surgical staples, leaving a small opening between the two portions.The patient’s stomach is manipulated to be much smaller and held in place with sutures.
Entry Method
Laparoscopic surgery is performed through 4 or 5 small abdominal incisions.Stomach stapling was performed through an abdominal incision.No incisions are used. The procedure is performed through the patient’s mouth and throat using an endoscope and the stitches are placed from the inside.

A Long-Needed Option For Weight Loss Patients

The non-surgical endoscopic sleeve gastroplasty procedure helps fill a void that has existed for much too long. Patients with lower BMI have needed options for getting their weight under control before they reached eligibility for bariatric surgery.

Individuals who do not desire to have surgery or may not be able to withstand surgery or recovery due to their health are often candidates for ESG. The procedure typically takes about an hour and the recovery is remarkable for three to four days for most patients.

Patients who continue to practice healthy lifestyle habits generally continue to lose weight, reach their weight loss goals, and maintain their healthy weight over the long term.

Only An Expert Endoscopist Should Perform ESG

Choosing the right doctor to perform your ESG procedure will be critical to the outcome. Make sure you do your research and choose a doctor who has extensive training in endoscopy and also in treating obesity and its comorbidities.

Dr. Okeefe Simmons at Simmons MD Advanced Weight Loss Solutions is the doctor you are looking for. He is expertly trained in the field of bariatric endoscopy and has an extensive background in obesity medicine and gastroenterology.

Looking at where we came from and how we have progressed to newer, safer, and more effective methods for weight loss, we can only believe that there is more to come. At Simmons Advanced Weight Loss Solutions, we are dedicated to making a difference in the obesity epidemic, one patient at a time.

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